<form id="data_section" method="post" enctype="multipart/form-data" action="CustomerDataManageServlet">
	<input type="hidden" name="action" id="action_to_update">
	<input type="hidden" name="ins_customerdata_id" id="hidden_customerdata_id">
	<input type="hidden" name="user_code" id="hidden_user_code" value="<%= session.getAttribute("userID") %>">
	
	<div id="tabs">
	  <ul>
	    <li><a href="#tabs-1">Hospital</a></li>
	    <li><a href="#tabs-2">President & Director</a></li>
	    <li><a href="#tabs-3">BJC</a></li>
	  </ul>
	  <div id="tabs-1">
	    <table class="tbl_search">
			<tr>
				<td>Region</td>
				<td colspan="2">
					<select name="ins_region" id="ins_region">
						<option value="">Please select..</option>
						<option value="1">Bangkok and Vicinity</option>
						<option value="2">Middle</option>
						<option value="3">North</option>
						<option value="4">East</option>
						<option value="5">West</option>
						<option value="6">South</option>
					</select>
				</td>
			</tr>
			<tr>
				<td>Hospital</td>
				<td colspan="2"><select name="ins_hospital_name" id="ins_hospital_name"></select></td>
			</tr>
			<tr>
				<td valign="top">Department</td>
				<td colspan="2"><select name="ins_hospital_department" id="ins_hospital_department"></select></td>
			</tr>
			<tr>
				<td>Type</td>
				<td colspan="2">
					<div id="div_ins_type">
						<input type="radio" name="ins_type" id="ins_type1" value="PV" checked="checked"><label for="ins_type1">Private</label>
						<input type="radio" name="ins_type" id="ins_type2" value="PB"><label for="ins_type2">Public</label>
					</div>
				</td>
			</tr>
			<tr>
				<td>Bed capacity</td>
				<td>
					<p>
					  range : 
					  <input type="text" name="ins_bed_min" id="ins_bed_min" class="textbox_stl" value="0" size="3"> -
					  <input type="text" name="ins_bed_max" id="ins_bed_max" class="textbox_stl" value="0" size="3"> 
					</p>
					<div id="ins_bed-capacity-range"></div>
				</td>
			</tr>
			<tr>
				<td valign="top">Address</td>
				<td colspan="2"><textarea name="ins_hospital_address" id="ins_hospital_address" cols="35" rows="3"></textarea></td>
			</tr>
			<tr>
				<td valign="top">Telephone</td>
				<td colspan="2"><input type="text" name="ins_hospital_telephone" id="ins_hospital_telephone" maxlength="40" size="40" class="textbox_stl"></td>
			</tr>
			<tr>
				<td valign="top">Email</td>
				<td colspan="2"><input type="text" name="ins_hospital_email" id="ins_hospital_email" maxlength="30" size="35" class="textbox_stl"></td>
			</tr>
		</table>
	  </div>
	  
	  
	  <div id="tabs-2">
	    <fieldset>
	    	<legend>President</legend>
	    	<table class="tbl_search">
	    		<tr>
	    			<td>Name</td>
	    			<td><input type="text" name="ins_president_name" id="ins_president_name" maxlength="50" size="45" class="textbox_stl"></td>
	    		</tr>
	    		<tr>
	    			<td>Telephone</td>
	    			<td><input type="text" name="ins_president_telephone" id="ins_president_telephone" maxlength="40" size="40" class="textbox_stl"></td>
	    		</tr>
	    		<tr>
	    			<td>Email</td>
	    			<td><input type="text" name="ins_president_email" id="ins_president_email" maxlength="30" size="35" class="textbox_stl"></td>
	    		</tr>
	    		<tr>
					<td>Rating of IMP </td>
					<td>
						<div id="div_ins_imp_rate_president">
							<input type="radio" name="ins_imp_rate_president" id="ins_imp_rate_president1" value="1" checked="checked"><label for="ins_imp_rate_president1">1</label>
							<input type="radio" name="ins_imp_rate_president" id="ins_imp_rate_president2" value="2"><label for="ins_imp_rate_president2">2</label>
							<input type="radio" name="ins_imp_rate_president" id="ins_imp_rate_president3" value="3"><label for="ins_imp_rate_president3">3</label>
							<input type="radio" name="ins_imp_rate_president" id="ins_imp_rate_president4" value="4"><label for="ins_imp_rate_president4">4</label>
							<input type="radio" name="ins_imp_rate_president" id="ins_imp_rate_president5" value="5"><label for="ins_imp_rate_president5">5</label>
						</div>
					</td>
				</tr>
				<tr>
					<td>Rating of RP </td>
					<td>
						<div id="div_ins_rp_rate_president">
							<input type="radio" name="ins_rp_rate_president" id="ins_rp_rate_president1" value="1" checked="checked"><label for="ins_rp_rate_president1">1</label>
							<input type="radio" name="ins_rp_rate_president" id="ins_rp_rate_president2" value="2"><label for="ins_rp_rate_president2">2</label>
							<input type="radio" name="ins_rp_rate_president" id="ins_rp_rate_president3" value="3"><label for="ins_rp_rate_president3">3</label>
							<input type="radio" name="ins_rp_rate_president" id="ins_rp_rate_president4" value="4"><label for="ins_rp_rate_president4">4</label>
							<input type="radio" name="ins_rp_rate_president" id="ins_rp_rate_president5" value="5"><label for="ins_rp_rate_president5">5</label>
						</div>
					</td>
				</tr>
	    	</table>
	    </fieldset>
	    <br>
	    <fieldset>
	    	<legend>Director</legend>
	    	<table class="tbl_search">
	    		<tr>
	    			<td>Name</td>
	    			<td><input type="text" name="ins_director_name" id="ins_director_name" maxlength="50" size="45" class="textbox_stl"></td>
	    		</tr>
	    		<tr>
	    			<td>Telephone</td>
	    			<td><input type="text" name="ins_director_telephone" id="ins_director_telephone" maxlength="40" size="40" class="textbox_stl"></td>
	    		</tr>
	    		<tr>
	    			<td>Email</td>
	    			<td><input type="text" name="ins_director_email" id="ins_director_email" maxlength="30" size="35" class="textbox_stl"></td>
	    		</tr>
	    		<tr>
					<td>Rating of IMP </td>
					<td>
						<div id="div_ins_imp_rate_director">
							<input type="radio" name="ins_imp_rate_director" id="ins_imp_rate_director1" value="1" checked="checked"><label for="ins_imp_rate_director1">1</label>
							<input type="radio" name="ins_imp_rate_director" id="ins_imp_rate_director2" value="2"><label for="ins_imp_rate_director2">2</label>
							<input type="radio" name="ins_imp_rate_director" id="ins_imp_rate_director3" value="3"><label for="ins_imp_rate_director3">3</label>
							<input type="radio" name="ins_imp_rate_director" id="ins_imp_rate_director4" value="4"><label for="ins_imp_rate_director4">4</label>
							<input type="radio" name="ins_imp_rate_director" id="ins_imp_rate_director5" value="5"><label for="ins_imp_rate_director5">5</label>
						</div>
					</td>
				</tr>
				<tr>
					<td>Rating of RP </td>
					<td>
						<div id="div_ins_rp_rate_director">
							<input type="radio" name="ins_rp_rate_director" id="ins_rp_rate_director1" value="1" checked="checked"><label for="ins_rp_rate_director1">1</label>
							<input type="radio" name="ins_rp_rate_director" id="ins_rp_rate_director2" value="2"><label for="ins_rp_rate_director2">2</label>
							<input type="radio" name="ins_rp_rate_director" id="ins_rp_rate_director3" value="3"><label for="ins_rp_rate_director3">3</label>
							<input type="radio" name="ins_rp_rate_director" id="ins_rp_rate_director4" value="4"><label for="ins_rp_rate_director4">4</label>
							<input type="radio" name="ins_rp_rate_director" id="ins_rp_rate_director5" value="5"><label for="ins_rp_rate_director5">5</label>
						</div>
					</td>
				</tr>
	    	</table>
	    </fieldset><br>
	    Remark <br><textarea name="ins_remark1" id="ins_remark1" cols="50" rows="3"></textarea>
	  </div>
	  <div id="tabs-3">
	  	<table class="tbl_search">
	  		<tr>
	  			<td>Department</td>
	  			<td><select name="ins_bjc_department" id="ins_bjc_department"></select></td>
	  		</tr>
	  		<tr>
	  			<td>Sale person</td>
	  			<td><input type="text" name="ins_sale_person" id="ins_sale_person" maxlength="40" size="50" class="textbox_stl"></td>
	  		</tr>
	  		<tr>
	  			<td>Product category</td>
	  			<td><select name="ins_bjc_category" id="ins_bjc_category"></select></td>
	  		</tr>
	  		<tr>
	  			<td>Brand</td>
	  			<td><select name="ins_bjc_brand" id="ins_bjc_brand"></select></td>
	  		</tr>
	  		<tr>
	  			<td>Model</td>
	  			<td><select name="ins_bjc_model" id="ins_bjc_model"></select></td>
	  		</tr>
	  		<tr>
	  			<td>1st competitor</td>
	  			<td><input type="text" name="ins_st_competitor" id="ins_st_competitor" maxlength="50" size="50" class="textbox_stl"></td>
	  		</tr>
	  		<tr>
	  			<td>2nd competitor</td>
	  			<td><input type="text" name="ins_nd_competitor" id="ins_nd_competitor" maxlength="50" size="50" class="textbox_stl"></td>
	  		</tr>
	  		<tr>
	  			<td>3rd competitor</td>
	  			<td><input type="text" name="ins_rd_competitor" id="ins_rd_competitor" maxlength="50" size="50" class="textbox_stl"></td>
	  		</tr>
	  		<tr>
	  			<td>Remark</td>
	  			<td><textarea name="ins_remark2" id="ins_remark2" cols="50" rows="3"></textarea></td>
	  		</tr>
	  	</table>
	  </div>
	</div>
	
</form>
<div id="output"></div>
